Back In MotionAspendale Gardens

The current lockdown situation with COVID-19 has meant that many of us have to work from home. As well as the adults, children have to attend school remotely and we are generally spending more time indoors than we probably were before. This means more time is spent on a laptop or ipad working or schooling, watching TV, reading or playing video games, often on the couch, bed or dining table. At our clinic, we have seen spike in lower back, mid-upper back and neck pain cases since the lockdown started. This is no coincidence!

These work spaces, while they may be comfortable at the time, are often less than ideal from a posture and ergonomics perspective. Creating a more ergonomic work space doesn’t require any fancy desks or expensive chairs (although they may help), and changing your posture when using these devices or working is something we can all do for free.

But what is the ideal desk set up? And how should you or your children be sitting while working or schooling? This week’s blog will provide advice regarding the impact a ‘poor’ posture can have on our body, how to adjust your home work space to be ergonomically sound, as well as other tips and tricks to minimise posture related pains.

How does poor posture effect my body?

When we sit in a less than ideal posture, a number of areas of stress may develop within your muscle tissue, spinal facet joints and discs. These stresses may be relieved once the offending posture is corrected or may continue to accumulate, slowly weakening the affected structure over time. Some examples of these positions are;

• Prolonged hunching while standing or sitting can cause your back, core, and abdominal muscles to become overloaded and eventually painful. This type of position means that our neck and thoracic spine (mid-back) muscles are required work hard for an extended period of time to maintain this posture. Furthermore, some of these muscles are simultaneously being stretched or lengthened, which makes the muscles have to work even harder to maintain this posture. Certain positions may also reduce the blood supply to a particular area.
• An unsupported sitting posture puts the spine in a forwardly bent position, known as a slump. If maintained and repeated, the load this slumped position places on the lumbar spine discs, muscles and ligaments can lead to pain, discomfort and, over a long period of time, degenerative changes to the intervertebral discs.
• Working on a laptop or reading while lying face down on your belly places you back and hips in an extended position (backward bend). This position may feel comfortable at the time but can lead to an aggravation of your spines facet joints.

Maintaining an upright posture often requires less effort to maintain than an incorrect posture. Changing from a habitual incorrect posture takes time and awareness to develop.

Desk setup

There is no ‘one size fits all’ desk setup, but there are a few important tips that will help to ensure you are in a position that is less susceptible to spinal pain. Try to align your desk setup with the measures outlined below;

• Leg position – try to have your knees at right angles with your feet flat on the floor, preferably on a soft surface such as carpet.
• Maintain a small, gap (about two fingers) between back of your knee and end of chair to avoid compression of blood vessels behind the knee.
• Your back rest should be slightly reclined (about 10-20 degrees from vertical is enough) with your whole spine supported by the backrest of the chair. Use a cushion or rolled up towel in the small or arch of your back – this will reduce the ‘slump’ in your lower back as discussed earlier.
• Try to have your forearms horizontal (ie. not slightly up or down when using the keyboard) and mostly supported by desk. Keep your shoulders relaxed.
• Set up the laptop or monitor height so that it is in line with your eyes and within arms reach. The further away your keyboard or monitor the more likely it is that you will extend your neck forward to look at the screen and the more strain you will put on your neck and back.

Postural and activity advice

Our bodies are built for movement and being physically active, no single position should be sustained for longer than 30 minutes. Any position that is maintained for an extended period of time will eventually become painful, no matter how ‘ideal’ a persons’ posture. Sometimes it is difficult to remember to get up and move around. There a few ways in which we can remind ourselves to get up and move;

• Set an alarm or a stop watch timer for 30 minutes – when the timer goes off, get up and move around. Even just a few minutes can go a long way.
• Use a small glass rather than a large bottle for your water – this will mean that you have to get up to fill the glass more frequently.
• Make small work related targets or goals –  when you reach those goals get up and move around.
• Try to schedule a daily walk for at least 30 minutes in the middle of your work or school day. This gives your postural muscles a bigger break and should mean by the end of the day you are less fatigued and sore.

The most important take-away from this blog is that we’re not built to sit in one position for hours on end. Try to be more conscious of how you are sitting or lying on the couch. Where possible complete your (school) work at a table or purpose made space. But most of all, stay active, keep moving and stay safe!

In the coming weeks we will discuss a range of stretches and exercises to help prevent your neck or back from becoming stiff and tight, that can be performed throughout the day and even without leaving the desk! If you are experiencing neck or back pain or would like to discuss your home office setup, book in to see a Physiotherapist or Exercise Physiologist at Back in Motion Aspendale Gardens here.

References:

1. Alamin, T. F., Agarwal, V., Zagel, A., Qeli, A. (2018). The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects. Journal of Spine Surgery, 4(3), 509.
2. Cheng, H. Y. K., Wong, M. T., Yu, Y. C., Ju, Y. Y. (2016). Work-related musculoskeletal disorders and ergonomic risk factors in special education teachers and teacher’s aides. BMC Public Health, 16(1), 137.
3. Cramer, H., Mehling, W. E., Saha, F. J., Dobos, G., Lauche, R. (2018). Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain. BMC musculoskeletal disorders, 19(1), 109.
4. McGill, S.M., Low Back Disorders: Evidence-Based Prevention and Rehabilitation. 3^rd edition Human Kinetics, Incorporated; 2015.
5. Kwon, Y., Kim, J. W., Heo, J. H., Jeon, H. M., Choi, E. B., Eom, G. M. (2018). The effect of sitting posture on the loads at cervico-thoracic and lumbosacral joints. Technology and Health Care, 26(S1), 409-418.
6. Yabe, Y., Hagiwara, Y., Sekiguchi, T., Momma, H., Tsuchiya, M., Kuroki, K., Nagatomi, R. (2018). Late bedtimes, short sleeping time, and longtime video-game playing are associated with low back pain in school-aged athletes. European Spine Journal, 27(5), 1112-1118.